不平等的跨步走向长寿。向健康公平多走一英里

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-10-08 DOI:10.1016/j.annepidem.2025.10.009

Borja del Pozo Cruz PhD , Francisco Perales PhD , Marcin Straczkiewicz PhD , Marcos Matabuena PhD , Jesús del Pozo-Cruz PhD , Rubén López-Bueno PhD

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引用次数: 0

摘要

目的研究不同社会经济阶层与每日步数相关的全因死亡风险降低的差异。方法前瞻性队列研究，使用NHANES数据（2011-2014），中位随访5.9年，7032例 美国18-80岁的成年人。暴露是使用家庭收入与贫困比率（RFIP；低<；1.30，中1.30 - 1.84，高≥1.85）按社会经济地位按加速计测量的每日步数进行分类。结果是通过与截至2019年12月的国家死亡指数的联系确定的全因死亡率。采用限制三次样条的Cox比例风险模型和相互作用的相对超额风险（rei）。结果在随访期间，452名参与者死亡。在所有社会经济群体中，较高的每日步数与降低的死亡风险有关。然而，与弱势群体相比，社会经济优势个体每1000步的风险降低幅度更大（低RFIP vs高RFIP的rri: -0.115, 95 % CI: -0.189, -0.042）。低RFIP的个体需要1.2-2.3 倍的步数才能达到高RFIP组的死亡率效益。结论：社会经济弱势群体可能不会从每日步数中获得同等的益处。解决造成这种差异的因素将有助于最大限度地提高步行对所有人的健康益处，从而减少整体健康差距。

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Unequal strides to longevity. The extra mile to health equity

Purpose

To examine differences in all-cause mortality risk reductions associated with daily steps across socioeconomic strata.

Methods

Prospective cohort study using NHANES data (2011–2014) with a median follow-up of 5.9 years among 7032 U.S. adults aged 18–80 years. Exposure was accelerometer-measured daily steps categorized by socioeconomic status using the Ratio of Family Income to Poverty (RFIP; low <1.30, medium 1.30–1.84, high ≥1.85). Outcome was all-cause mortality determined via linkage to the National Death Index through December 2019. Cox proportional hazards models with restricted cubic splines and Relative Excess Risk due to Interaction (RERI) were applied.

Results

Over the follow-up, 452 participants died. Higher daily steps were associated with reduced mortality risk in all socioeconomic groups. However, socioeconomically advantaged individuals experienced greater risk reductions per 1000 daily steps compared to disadvantaged groups (RERI for low vs. high RFIP: –0.115, 95 % CI: –0.189, –0.042). Individuals with low RFIP required 1.2–2.3 times more steps to match the mortality benefits seen in high RFIP groups.

Conclusions

Socioeconomically disadvantaged populations may not benefit equally from daily steps. Addressing the factors contributing to this discrepancy will help maximize the health benefits of walking for all, thereby reducing overall health disparities.

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来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.